Archived: Long Lea Home Support

Long Lea Home Support is a medium sized independent domiciliary care agency that provides personal care and support to people in their own homes in North Warwickshire. People who receive a service include those living with physical frailty due to older age and / or health

conditions including Parkinson’s disease and dementia. At the time of the inspection the agency was providing a service to 56 people. Visits to people ranged from quarter of an hour up to a 24 hour service. The frequency of visits ranged from several visits each day to a weekly visit depending on people’s individual needs.

The service had a registered manager. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated Regulations about how the service is run. The registered manager had oversight of the service, but an ‘operational manager’ oversaw the day to day running of the service.

The service was last inspected on 16 and 19 October 2015, when we found the provider was compliant with the fundamental standards described in the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. However, the service was awarded an overall rating of 'requires improvement'. This was because procedures and policies were not always followed to ensure people consistently received safe, effective and responsive care. The provider’s quality assurance checks did not identify when improvements needed to be made.

At this inspection, we checked to see if improvements had been made. We found some

actions had been taken and improvements had been made, but there were still areas where improvement was needed.

People’s care records did not always include the information staff needed to be able to meet and respond to people’s identified needs, but plans were in place to further improve care plans as the provider moved to an electronic care records system.

Risk assessments were mostly in place, and the provider planned to improve the way risk was assessed and recorded. However, some risk assessments were not available for us to review, and in some cases where risk had been identified, risk assessments had not been completed.

Records of pre-employment checks made prior to staff starting work, were not always clear enough to demonstrate the provider ensured people were protected.

People were supported with their medicines by staff who were trained and assessed as competent to give medicines safely. People told us their medicines were given in a timely way and as prescribed, and records showed this.

People told us they felt safe and comfortable with the staff who supported them. Staff received training in how to safeguard people from abuse, and were supported by the provider who acted on concerns raised and ensured staff followed safeguarding policies and procedures.

There were enough staff to keep people safe, and staff mostly supported people as and when agreed in their care plans.

People and their relatives told us staff mostly had the skills and knowledge they needed to support people effectively. Staff had regular supervision meetings, and their practice was observed and assessed regularly to ensure they remained effective in their role.

People told us staff asked for consent before providing them with support. Information on the support people needed with decision making was not always clearly recorded. Staff and the registered manager had a reasonable understanding of the Mental Capacity Act 2005.

People had access to health professionals when needed, and care records showed support provided was in line with what had been recommended.

People told us staff were kind and caring and treated them with dignity. People were supported to make choices about their day to day lives. People’s care records were written in a way which helped staff to deliver personalised care and gave staff information about people’s communication, their likes, dislikes and preferences.

People and their relatives knew how to complain, and complaints were dealt with according to the provider’s policy and procedure.

There were systems in place to monitor the quality of the support provided, and these had been used to develop action plans to help the service improve. Key messages were shared with staff through team meetings, and staff felt well supported by the senior management team.

Below is a summary of what we found. The summary is based on our findings during the inspection, speaking with people using the service, their relatives, the staff supporting them and from looking at records. If you wish to see the evidence supporting our summary please read the full report.

Is the service safe?

People and relatives we spoke with told us they were satisfied with the care and support provided by staff working for the service.

They told us the staff appeared competent and well trained, and they felt safe when they received care. Comments included, "They are very good and look after him well" and "I can't fault them, I feel safe with them."

People and relatives we spoke with told us staff were on time for their calls and stayed for the time people expected them to. They said, "They always arrive on time" and "They arrive on time and stay for the correct length of time."

Is the service effective?

The provider carried out assessments of people's care and support needs prior to agreeing to provide a service for people. Records demonstrated that people or their relatives were involved in the assessment of their care and support needs.

People who were unable to advocate for themselves were supported by family members. The registered manager was aware of the Mental Capacity Act 2005 and said that this would be followed if it became necessary.

Is the service caring?

We spoke with two people who used the service and four relatives. The feedback we received indicated that people were happy with the care and support they received. For example, we were told, "I'm extremely pleased with the care", "Very, very pleased, they always discuss what I need or want them to do before they start" and "We are very happy with the service, nothing seems too much trouble."

Staff we spoke with told us they enjoyed their jobs. They told us they supported people in a kind and caring manner. "I always ask people what they want me to do" and "I always ask people how they are when I first arrive as it's important to find out what they have to say," are examples of comments made.

Is the service responsive?

Systems and processes were in place to monitor and manage accidents, incidents and complaints. These clearly recorded the nature of the accident, incident or concern; the action taken and the steps followed to ensure that learning took place and any future occurrences were minimised.

People were asked for their views about the service provided. The responses received from people were analysed and used to make improvements to the service.

Is the service well led?

There were processes and systems in place to monitor the service provided. The provider used the information gathered through these processes to assess and improve the quality of service for people.

Staff understood their roles and received support and training on a regular basis to ensure that they were competent to provide the care and support to the required standard.